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Nuffield > Cardiovascular Disease And Blood Pressure > Flashcards

Cardiovascular Disease And Blood Pressure Flashcards

1
Q

Diseases classified as CVD

A 
CHD
Stroke
Atherosclerosis
CardioMyopathy
Heart Valve Disease
Arrythmias
Hypertension
Hyoptension
Endocarditis 
Congenital heart disease
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2
Q

Causes of atherosclerosis

A
  • Hereditary Factors
  • Hyperlipidemia
  • Hypertension
  • Diabetes
  • Obesity
  • Physical inactivity
  • Smoking
  • Age
  • Males?
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3
Q

Layers of Blood Vessel

A

1- Tunica Adventitia: outer layer
2- Tunica Media: Contains smooth muscle and elastic tissue
3- Tunica Intima - Monolayer of endothelial cells

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4
Q

What is Inflammation?

A

Increased Blood flow to an area

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5
Q

Step 1 of Atherosclerosis

A
  • ENDOTHELIAL DYSFUNCTION
  • Dysfunction to endothelium
  • Adhesion Molecules
  • Adhesion of Monocytes
  • Dysfunction characterised by a reduction in the bioavalibility of Nitric Oxide (vasodilator)
  • Decreased release of anti-thrombotic cytokines
  • ET-1 Causes the release of free radicals and pro-inflammatory cytokines
  • Interleukin 1 and tumour necrosis factor alpha promote leukocyte adhesion and activation
  • Increased release in growth factors
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6
Q

Step 2 of Atherosclerosis

A

MIGRATION OF MONOCYTES

  • Monocytes enter the tissue –> Macrophages
  • Macrophages consume modified LDL –> Foam cells
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7
Q

Step 3 of Atherosclerosis

A

LESION PROGRESSION

  • Migration and proliferation of SMC from tunica media to tunica intima
  • Regulated by Growth factors
  • SMC’s become intermixed with the area of inflammation to form an intermediate lesion
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8
Q

Step 4 of Atherosclerosis

A

RUPTURE

  • the onset of plaque rupture is a complex process
  • Some plaques are more vulnerable than others
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9
Q

What is Myocardial Ischaemia

A
  • Reduced oxygen (blood flow) to the heart cells. reduced blood flow in the coronary arteries due to fixed vessel narrowing and abnormal vascular tone.
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10
Q

Objective signs of Ischaemia

A
  • Changes in ECG pattern
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11
Q

Term for Ischeamic chest discomfort

A
  • Angina
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12
Q

Types of angina

A
  • Stable
  • Unstable
  • Prinzmetals
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13
Q

Risk Measurement for heart attack and stroke?

A

QRisk 3

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14
Q

Control of blood pressure?

A

Local control
- Autoregulation
Neural Control
- Vasomotor Centre
- Baroreflexes, Chemoreflexesand medullary ischemia reflex
Hormonal Control
- Renin-Angiotensin-Aldosterone system (RAA)

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15
Q

Stages of the RAA system

A

1- Renin Production
2- Renin and Angiotensin
3- Angiotensin 2 effects

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16
Q

Renin Production

A

-Released into circulation by Kidney
- Stimulated by
1- SNS
2- Renal artery Hypotension
3- Decreased sodium delivery to distal tubules of the kidneys

17
Q
  1. Renin and Angitensin
A

when Renin is released into the blood it acts upon angiotensinogen:

  • Renin turns Antgiotensinogen into angiotensin 1
  • ACE turns Angiotensin 1 into 2
18
Q
  1. Angiotensin 2 Effects
A

1- Acts on adrenal cortex to release aldosterone which aids sodium re absorption
2- Sodium re absorption aiding water retention
3- Enhances SNS adrenergic function
4- Stimulates ADH release from the posterior Pituitary Gland
5- Constriction of arteriolar vessels

19
Q

Hypotension

A

Classified as <90/60

20
Q

Long term problems of Hypertension

A

Macro-vascular (Stroke, TIA, CAD, CVD, Peripheral vascular disease, congestive cardiac failure)
Micro-vascular (Renal damage and renal failure, Retinal vascular disease)

21
Q

Lifestyle interventions for hypertension

A 
1- Smoking
2- Reduced salt intake
3- Weight Reduction
4- Increased Exercise and activity
5- Reduced Alcohol
6- Increased Fruit and Veg
7- Reduced Caffeine intake
8- Relaxation and stress management
22
Q

Korotoff sounds

A 
Silence
Phase 1 - Tapping sound
Phase 2 - Soft Swishing
Phase 3- Crisp 
Phase 4 - Blowing
Phase 5 - Silence
23
Q

What to do if BP is higher than 140/90 in clinic?

A

1- Take another measurement
2- Make a record of both
3- Record the lowest
4- If it’s still outside range, refer

Nuffield (18 decks)

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